The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Renal Insufficiency Secondary to Leukemic Infiltration in Chronic Lymphocytic Leukemia: A Case Report

백혈병 침윤으로 인한 신기능 이상을 보인 만성림프구백혈병 1예

  • Kim, Jin-Suk (Department of Internal Medicine, Inje University Ilsan Paik Hospital) ;
  • Kim, Hyung-Yoon (Department of Internal Medicine, Inje University Ilsan Paik Hospital) ;
  • Lee, Han-Sang (Department of Internal Medicine, Inje University Ilsan Paik Hospital) ;
  • Lee, Hae-Ran (Department of Internal Medicine, Inje University Ilsan Paik Hospital) ;
  • Kim, Han-Seong (Department of Pathology, Inje University Ilsan Paik Hospital) ;
  • Park, Ji-Yeon (Department of Radiology, Myongji Hospital, Kwandong University College of Medicine) ;
  • Yi, Seong-Yoon (Department of Internal Medicine, Inje University Ilsan Paik Hospital)
  • 김진숙 (인제대학교 일산백병원 내과) ;
  • 김형윤 (인제대학교 일산백병원 내과) ;
  • 이한상 (인제대학교 일산백병원 내과) ;
  • 이혜란 (인제대학교 일산백병원 내과) ;
  • 김한성 (인제대학교 일산백병원 병리과) ;
  • 박지연 (관동대학교 의과대학 명지병원 영상의학과) ;
  • 이성윤 (인제대학교 일산백병원 내과)
  • Published : 2012.07.01
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Abstract

Renal infiltration is common in chronic lymphocytic leukemia (CLL), but renal impairment caused by leukemic infiltration is rare. This report describes the case of a 38-year-old man with CLL who required no medical treatment for 1 year and was admitted with nonoliguric renal insufficiency (proteinuria > 2,000 mg/day). A renal biopsy subsequently revealed leukemic infiltration by CLL. Treatment with fludarabine plus cyclophosphamide resulted in the improvement of renal function. Leukemic infiltration should be considered in the differential diagnosis of a patient with CLL and impaired renal function because renal impairment often responds well to chemotherapy.

CLL은 성숙 B림프구의 악성 변화와 림프절, 간, 비장 및 골수 침범을 특징으로 하며, 대개 만성적인 경과를 취한다. CLL의 신장 침윤은 비교적 흔하지만, 이로 인한 신기능 이상은 드물게 발생한다. CLL 환자에서 원인이 불분명한 신기능 이상이 발생한다면, 병기에 무관하게 신장 침범을 배제하기 위한 생검을 고려해야 한다. 신기능의 회복은 가역적인 경우가 많고, 치료에 대한 반응은 좋다. 저자들은 CLL을 진단받고 경과를 보던 중에 심한 단백뇨와 신기능 저하가 발생하여 실시한 신장생검에서 백혈병 침윤이 확인되어 복합항암화학요법 이후에 호전된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

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